Is Local Excision of T2/T3 Rectal Cancers Adequate?

Beral, Daniel L.; Monson, J. R. T.

doi:10.1007/3-540-27449-9_14

Cited by 10 publications

(10 citation statements)

References 43 publications

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“…Whether a combination of local resection combined with radiation therapy reliably improves longterm survival in these patients remains unclear [17]. The question whether local excision of patients with T1 highrisk cancer or even T2 stages is justified requires randomized trials comparing radical surgery with local excision, with or without adjuvant treatment [2,8]. However, because of the paucity of such highly selected cases, these trials will be difficult to perform.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic posterior mesorectal resection as an option to combine local treatment of early stage rectal cancer with partial mesorectal lymphadenectomy

Köninger

Müller‐Stich

Autschbach

et al. 2007

Langenbecks Arch Surg

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The technique of "Endoscopic posterior mesorectal resection" represents an interesting option in the surgical treatment of rectal cancer, as it allows for the first time an organ preserving resection of local lymph nodes in the small pelvis. It may evolve as an efficient new staging procedure to identify patients with metastatic disease who may benefit from multimodal treatment or extended surgery.

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Section: Discussionmentioning

confidence: 99%

Endoscopic posterior mesorectal resection as an option to combine local treatment of early stage rectal cancer with partial mesorectal lymphadenectomy

Köninger

Müller‐Stich

Autschbach

et al. 2007

Langenbecks Arch Surg

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“…Classic and reasonable indications for rectal tumors local resection include T1, T2 mobile tumors, with adequate histological aspects (well or moderately differentiated, with no angiolymphatic invasion) [16][17][18]. Some references comparing transanal excision and radical resections demonstrated that low risk T1 lesions present similar survival and recurrence rates, with local excision, showing smaller hospitalization and surgical time, less analgesia and blood loss and less early and late morbidities.…”

Section: Discussionmentioning

confidence: 99%

Transanal Endoscopic Operation - A New Proposal

Rocha¹,

Féres²

2011

Endoscopic Procedures in Colon and Rectum

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“…3,9,12,29 Classic and reasonable indications for rectal tumors local resection include T1, T2 mobile tumors, with adequate histological aspects (well or moderately differentiated, with no angiolymphatic invasion). 14,16,17 Some references comparing transanal excision and radical resections demonstrated that low risk T1 lesions present similar survival and recurrence rates, with local excision, showing smaller hospitalization and surgical time, less analgesia and blood loss and less early and late morbidities. Data on T2 lesions are controversial.…”

Section: Discussionmentioning

confidence: 99%

“…Also, there is no randomized prospective studies and there is a lot of variation concerning the adjuvant therapy indication. 1,2,14,16,17,19 Another relevant aspect for literature data comparison is the biological characterization of the tumor, i.e., interaction tumor-host, which might be inferred by the morphology, histology, size, localization and invasive stage. This is essential for the therapeutic results comparison in patients with similar disease stages.…”

Section: Discussionmentioning

confidence: 99%

“…However, specific criteria for these tumors selection are still not universally accepted. 2,[14][15][16][17] Some parameters are indicated as requisites for determination of which tumors are theoretically adequate for transanal LE: smaller than 4 cm, mobile, restricted to only one quadrant, placed up to 10 cm of the anorectal line, well differentiated, with no lymphovascular or lymphonodal invasion, and endoscopic, tomographic and nuclear magnetic resonance evaluations that demonstrate that lesions are T1, T2 with no metastatic lesions. 18 The results of local treatment of rectal cancer are of difficult interpretation because the literature brings retrospective analysis of heterogeneous groups of patients, with different surgical indications and adjuvant therapies, while it lacks prospective homogeneous studies.…”

Section: Introductionmentioning

confidence: 99%

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Transanal endoscopic operation: a new proposal

Rocha

Féres

2008

Acta Cir. Bras.

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Purpose: The transanal procedure for rectal cancer surgery is one of the many techniques currently available. Different techniques for local excision of rectal tumors include: conventional transanal technique, posterior access surgery, therapeutic colonoscopy, transanal endoscopic surgery. Methods: The aim of the present study is to describe a new method of transanal endoscopic resection, transanal endoscopic operation (TEO), and performed with the aid of a surgical proctoscope especially designed for this purpose and report the results obtained in 32 patients submitted to the TEO and to compare these results with those obtained with other techniques currently available. The average proportions of recurrence, postoperation complications and posterior resections were analyzed by means of a metanalysis. Data on the distance and size of rectal lesions, the operative timing and hospitalization time were distributed in graphs according to authors and techniques. Results: The results were favorable and equivalent to those described in the literature. Conclusions: The surgical proctoscope specially designed for this study is efficient and has a low cost; the TEO is easily performed with the aid of this equipment; the final results were favorable and similar to those obtained with other available techniques for endoscopic transanal intestinal resection, which are of high cost and less availability.Key words: Rectal Surgery. Endoscopy. RESUMOIntrodução: A operação cirúrgica por acesso transanal no tratamento do câncer retal é uma das várias técnicas utilizadas nessa terapêutica. Há várias técnicas de excisão local para os tumores retais: O método cirúrgico transanal convencional, acessos posteriores, colonoscopia terapêutica e operações transanais endoscópicas. O objetivo é apresentar um novo método de ressecção transanal endoscópica (Operação Transanal Endoscópica -OTE), realizada com um proctoscópio cirúrgico idealizado para o procedimento e divulgar os resultados obtidos em 32 pacientes submetidos a OTE e compará-los com as técnicas atualmente empregadas. Métodos: Foram analisadas as proporções médias da recorrência, das complicações pós-operatórias e das ressecções posteriores por meio da técnica de metanálise. Para a distância e o tamanho das lesões retais, os tempos de operação e de hospitalização, foram feitos gráficos de acordo com o autor e a técnica. Resultados: Os resultados foram favoráveis e equiparáveis aos trabalhos analisados. Conclusão: Concluiu-se que: O proctoscópio utilizado na OTE demonstrou ser eficaz e de baixo custo; 2 -A OTE mostrou-se factível; 3 -A análise dos resultados com a OTE foram satisfatórios e similares às outras técnicas de ressecções transanais endoscópicas que são de alto custo e pouco disponíveis em nosso meio.Descritores: Cirurgia Retal. Endoscopia. Rocha JJR et al 94

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Is Local Excision of T2/T3 Rectal Cancers Adequate?

Cited by 10 publications

References 43 publications

Endoscopic posterior mesorectal resection as an option to combine local treatment of early stage rectal cancer with partial mesorectal lymphadenectomy

Endoscopic posterior mesorectal resection as an option to combine local treatment of early stage rectal cancer with partial mesorectal lymphadenectomy

Transanal Endoscopic Operation - A New Proposal

Transanal endoscopic operation: a new proposal

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